New Breakthrough: Non-Invasive
Therapy Boosts Spinal Cord Injury Recovery

Editor’s Note: Scientists at Shirley Ryan AbilityLab found that a non-invasive electrical stimulation known as Hebbian Stimulation, combined with physical therapy, improved walking and grasping in spinal cord injury patients. Led by Dr. Monica Perez, the research used this technique to enhance connections between spinal and motor neurons. In one study, participants receiving 40 sessions showed significant improvements in walking speed, corticospinal function, grasping, and quality of life. The more sessions, the better the outcomes, with a pronounced improvement in walking speed for those receiving 40 sessions. The study, funded by NIH, VA, and Walkabout Foundation, aims to explore further functional improvements beyond 40 sessions.

Dr. Monica Perez PT, PhD

In a recent conversation with Dr. Perez, we discussed her research and the implications it could have for SCI treatment.

What exactly is Hebbian stimulation and who is it for?

Dr. Perez: “We are using the protocol for people with spinal cord injury and the procedure aims to enhance recovery. We stimulate nerves and pathways coming from the brain at specific times that allow us to try to improve synaptic connections that are still available.”

Why is Hebbian stimulation so important?

Dr. Perez: “This technique is based on principles of spike-timing dependent plasticity, a process that partially explains the activity-dependent development of the nervous system. We were able to reproduce some of those principles noninvasively in humans and use that to promote recovery.”

Can this therapy be done immediately post injury – or must patients be somewhat stabilized first?

Dr. Perez: “This type of stimulation can be done soon after the injury, but we have mainly focused for now on chronic injuries.”

Can this type of stimulation help patients with quadriplegia?

Dr. Perez: “The beauty of this technique is that we can target different muscle groups that are affected by the injury, which is called multi-site stimulation. So, for example, in people with incomplete quadriplegia, we can target arms and leg muscles simultaneously. This is why we think the concept of the multi-site is extremely important, not only scientifically but functionally, because people with cervical injuries have deficits in upper and lower limb function. So, the idea is to have a therapy that can now address physical issues globally.”

Are there any side effects to this type of therapy?

Dr. Perez: “We have not seen side effects. This is, I think, the most important part of the technique…that it is noninvasive and uses neurostimulation procedures that are widely used in clinical neurophysiology.

How long lasting is this type of therapy for those with SCI?

Dr. Perez: “In our last publication we were able to show that individuals maintain those changes for nine months after the intervention.”

What are the next steps in this type of therapy?

Dr. Perez: We are one of the few groups, if not the only one, who is using multi-site therapy for spinal cord injury recovery. And we are also trying to combine the stimulation with certain types of medication to even further the recovery.

Where is the best place for people to go for this treatment? How can they sign up for it and what is the cost?

Dr. Perez: “After interested patients are screened and tested for their level of connectivity. Then, if you qualify and are part of our research project there is no cost. We don’t charge for the protocol because it will help us to better understand the effect of this type of therapy. The enrollment is open now.”

Dr. Monica Perez, is Scientific Chair, Arms + Hands Lab, Shirley Ryan AbilityLab | Professor of Physical Medicine and Rehabilitation, Northwestern University, Research Scientist Edward Hines Jr., VA Hospital [email protected], @MonicaPerezPhD

For information about the trial, contact Sri Vemulakonda ([email protected]). The researchers are creating a registry of people who want to be involved.

For the full study, visit: https://pubmed.ncbi.nlm.nih.gov/36843340/

For a more detailed explanation of the procedure from the Shirley Ryan Ability Lab and its current outcomes click here.

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